3 ms·

Though my understanding is that the survival rate of a covid19 patient once he requires a ventilator is around 50%. If that's true, at worst, if we ran out of v

by cm2187 7y ago

Though my understanding is that the survival rate of a covid19 patient once he requires a ventilator is around 50%. If that's true, at worst, if we ran out of ventilators, the death rate would double. That's bad and we should avoid it but the doubling of a tiny number will still be a small number. Which is why I am still confused by the ratio of 1:10 that the White House has shown between the death toll under lockdown vs no lockdown. For the reason above, I would only expect the death rate to double. No lockdown means a lot more people get infected faster. But lockdown still requires to build herd immunity, we are only slowing it down. So the same number of people will get infected ultimately. So either they implied that the lockdown would be permanent until we get a vaccine (at best 2021 Q1), or it completely disregarded what happened after the initial few weeks of lockdown and then the numbers were at best grossly misleading.

jpxw 7y ago
Some 15% of people become “seriously” unwell, and require medical intervention such as oxygen. In a situation where the peak is hit unmitigated, these people will not get the medical care they need, and a lot of them will die.
- cm2187 7y ago
  The 15% looks implausible given the fatality rates mentioned here. But I would expect a lot of the medical care to be scalable so unmitigated doesn't mean no medical care. We have been building field hospitals in the UK and US (though have barely used them so far), using hotels, etc. Providing oxygen should be fairly straightforward. I understood ventilators was the part that caused a serious scalability bottleneck.
  - yomly 7y ago
    Yes - part of the strategy of flattening the curve is to buy time to scale capacity. Dedicated covid19 hospitals also have the advantage of isolating covid19 patients from high risk non-covid19 patients (e.g immunocompromised cancer patients) As the disease is so easily transmitted hospitals are partly buckling due to contamination within hospitals. A regular 50 year old probably has a good chance of surviving coronavirus. A 50 year old who is midway through chemo, probably less so... All of this nuance is hard to express through topline death tolls and mortality rates.
    - TheOtherHobbes 7y ago
      The "We shouldn't have killed our economy for this" online comments miss some obvious truths - which is that the economy would be crippled by a high peak regardless. At best people wouldn't go to work, at worst they'd struggle in and pass out - or maybe die - in front of their coworkers. So the economy would have ground to a halt anyway as people stayed at home to protect themselves. But it would have done it in an uncontrolled way that didn't inspire confidence in a return to normality. Which is the economic reason for flattening the peak. Serious damage was always inevitable, but there's a huge difference between a barely controlled but orderly temporary shutdown with mitigation measures, and a shutdown caused by mass panic and paranoia. In fact even laggard countries have been forced to take some measures, because when their lives are at risk people and their managers act on their own initiative no matter what the official line is.
      - cm2187 7y ago
        I suspect you are assuming a large proportion of people who get the virus have severe symptoms. The evidence of the contrary seems to emerge.
      - guenthert 7y ago
        Old people, those in the middle of a chemotherapy and many other people at risk aren't going to work and hence won't die in front of their coworkers.
chiefalchemist 7y ago
We've been on lockdown because approx 1% of the US population has tested positive. That means 99% are not. How can we come out of lockdown when we are effectively still where we started. We're not even close to herd immunity.
- cm2187 7y ago
  Not sure I agree with your numbers but I agree with your point, we are very likely quite far from herd immunity. Which means another 18 months in lockdown if we want to stay well within the current ICU capacity until a vaccine is mass produced. Which means an economic downturn not only worse than 2008 (it will be worse already assuming we leave lockdown in a few weeks), but many times worse. Or we can swallow this thing. It will mean more deaths. Trump says 10 times more. What I am saying is that I don’t understand how he gets there. If it is “only” two times more, then we need to have an adult conversation on how many lives are worth saving vs our society going through something akin to the great depression.
  - bigbob2 7y ago
    > If it is “only” two times more, then we need to have an adult conversation on how many lives are worth saving vs our society going through something akin to the great depression. Why is it that only two choices ever exist when this argument is presented? Choose either death by virus or death by status quo economy. It seems like a more pleasant alternative would be reshaping our economic systems to be more resilient against such a crisis which will almost certainly occur again in the future. Maybe the current ownership and distribution models and how they relate to globalism aren't compatible with something that is now simply a fact of life.
    - cm2187 7y ago
      The ownership and distribution models aren't the problem. The problem is that while everyone is locked up at home, no one consumes, we don't go to restaurants, to malls, we don't do tourism. And in some case we don't produce either, construction is halted, etc. There is almost no economic activity going on. No economic model works when everyone is effectively on house arrest.
graycat 7y ago
> But lockdown still requires to build herd immunity, we are only slowing it down. So the same number of people will get infected ultimately. Yes. I've been saying that, too. So, in blunt terms, currently we are trying to keep people alive until we can get therapeutics and/or vaccines that confer immunity so that we can get to herd immunity with fewer infections and deaths.
jimbokun 7y ago
The actual CDC recommendations are here: https://fm.cnbc.com/applications/cnbc.com/resources/editorialfiles/2020/04/16/WHReopeningDoc.pdf https://fm.cnbc.com/applications/cnbc.com/resources/editoria...
nradov 7y ago
The survival rate of a COVID-19 patient once he requires a ventilator is closer to 20%. So running out of ventilators wouldn't double the death rate. https://www.sfgate.com/news/medical/article/Some-doctors-moving-away-from-ventilators-for-15187546.php https://www.sfgate.com/news/medical/article/Some-doctors-mov...

by cm2187 7y ago

jpxw 7y ago

Some 15% of people become “seriously” unwell, and require medical intervention such as oxygen. In a situation where the peak is hit unmitigated, these people will not get the medical care they need, and a lot of them will die.

cm2187 7y ago
The 15% looks implausible given the fatality rates mentioned here. But I would expect a lot of the medical care to be scalable so unmitigated doesn't mean no medical care. We have been building field hospitals in the UK and US (though have barely used them so far), using hotels, etc. Providing oxygen should be fairly straightforward. I understood ventilators was the part that caused a serious scalability bottleneck.
- yomly 7y ago
  Yes - part of the strategy of flattening the curve is to buy time to scale capacity. Dedicated covid19 hospitals also have the advantage of isolating covid19 patients from high risk non-covid19 patients (e.g immunocompromised cancer patients) As the disease is so easily transmitted hospitals are partly buckling due to contamination within hospitals. A regular 50 year old probably has a good chance of surviving coronavirus. A 50 year old who is midway through chemo, probably less so... All of this nuance is hard to express through topline death tolls and mortality rates.
  - TheOtherHobbes 7y ago
    The "We shouldn't have killed our economy for this" online comments miss some obvious truths - which is that the economy would be crippled by a high peak regardless. At best people wouldn't go to work, at worst they'd struggle in and pass out - or maybe die - in front of their coworkers. So the economy would have ground to a halt anyway as people stayed at home to protect themselves. But it would have done it in an uncontrolled way that didn't inspire confidence in a return to normality. Which is the economic reason for flattening the peak. Serious damage was always inevitable, but there's a huge difference between a barely controlled but orderly temporary shutdown with mitigation measures, and a shutdown caused by mass panic and paranoia. In fact even laggard countries have been forced to take some measures, because when their lives are at risk people and their managers act on their own initiative no matter what the official line is.
    - cm2187 7y ago
      I suspect you are assuming a large proportion of people who get the virus have severe symptoms. The evidence of the contrary seems to emerge.
    - guenthert 7y ago
      Old people, those in the middle of a chemotherapy and many other people at risk aren't going to work and hence won't die in front of their coworkers.

chiefalchemist 7y ago

We've been on lockdown because approx 1% of the US population has tested positive. That means 99% are not. How can we come out of lockdown when we are effectively still where we started. We're not even close to herd immunity.

cm2187 7y ago
Not sure I agree with your numbers but I agree with your point, we are very likely quite far from herd immunity. Which means another 18 months in lockdown if we want to stay well within the current ICU capacity until a vaccine is mass produced. Which means an economic downturn not only worse than 2008 (it will be worse already assuming we leave lockdown in a few weeks), but many times worse. Or we can swallow this thing. It will mean more deaths. Trump says 10 times more. What I am saying is that I don’t understand how he gets there. If it is “only” two times more, then we need to have an adult conversation on how many lives are worth saving vs our society going through something akin to the great depression.
- bigbob2 7y ago
  > If it is “only” two times more, then we need to have an adult conversation on how many lives are worth saving vs our society going through something akin to the great depression. Why is it that only two choices ever exist when this argument is presented? Choose either death by virus or death by status quo economy. It seems like a more pleasant alternative would be reshaping our economic systems to be more resilient against such a crisis which will almost certainly occur again in the future. Maybe the current ownership and distribution models and how they relate to globalism aren't compatible with something that is now simply a fact of life.
  - cm2187 7y ago
    The ownership and distribution models aren't the problem. The problem is that while everyone is locked up at home, no one consumes, we don't go to restaurants, to malls, we don't do tourism. And in some case we don't produce either, construction is halted, etc. There is almost no economic activity going on. No economic model works when everyone is effectively on house arrest.

graycat 7y ago

> But lockdown still requires to build herd immunity, we are only slowing it down. So the same number of people will get infected ultimately. Yes. I've been saying that, too. So, in blunt terms, currently we are trying to keep people alive until we can get therapeutics and/or vaccines that confer immunity so that we can get to herd immunity with fewer infections and deaths.

jimbokun 7y ago

The actual CDC recommendations are here: https://fm.cnbc.com/applications/cnbc.com/resources/editorialfiles/2020/04/16/WHReopeningDoc.pdf https://fm.cnbc.com/applications/cnbc.com/resources/editoria...

nradov 7y ago

The survival rate of a COVID-19 patient once he requires a ventilator is closer to 20%. So running out of ventilators wouldn't double the death rate. https://www.sfgate.com/news/medical/article/Some-doctors-moving-away-from-ventilators-for-15187546.php https://www.sfgate.com/news/medical/article/Some-doctors-mov...